The Dangers of Stopping Guanfacine Cold Turkey

1. Guanfacine (2-6 mg/day) a centrally acting antihypertensive drug, was effective in controlling blood pressure in 5 essential hypertensives and lowered plasma noradrenaline and urinary catecholamine excretion. 2. Withdrawal of guanfacine by blind substitution of identical placebo tablets under observation in hospital led to a gradual recovery of blood pressure over 2-4 days. 3. Salivary flow, which was reduced on guanfacine, returned to pretreatment levels by 2 days after withdrawal and significantly exceeded control for the next two days. 4. Urinary catecholamine excretion returned to pretreatment levels by 3 days but did not exceed control levels during the period of study. 5. Plasma noradrenaline returned gradually to pretreatment levels, and by day 4 significantly exceeded them. 6. No patient experienced symptoms suggesting catecholamine excess although four out of five reported a headache from the second day onwards. 7. Guanfacine, a centrally acting drug which pharmacologically resembles clonidine, has a slow offset of hypotensive effect over 2-3 days. Symptoms or biochemical evidence of catecholamine excess were not encountered within 48 h of withdrawal, possibly reflecting the longer duration of action and plasma half-life of guanfacine.

Guanfacine sold under the brand name Intuniv is a prescription medication used to treat attention deficit hyperactivity disorder (ADHD). It works as a non-stimulant by regulating nerve impulses in the brain that influence hyperactivity and impulsiveness. While guanfacine can be an effective ADHD treatment, some people consider stopping their medication cold turkey. However, abruptly stopping guanfacine can be dangerous and should be avoided.

What Happens When You Quit Guanfacine Cold Turkey?

Guanfacine should never be stopped suddenly without first consulting your prescribing doctor. This medicine must be tapered off slowly under medical supervision. Quitting guanfacine abruptly can lead to potentially serious withdrawal symptoms such as:

  • Rebound hypertension – Sudden stopping guanfacine risks a quick spike in blood pressure and pulse rate. This is known as rebound hypertension.

  • Dizziness and fainting – The abrupt blood pressure changes from guanfacine withdrawal can result in lightheadedness, vertigo, and fainting.

  • Headaches and migraines – Many people experience bad headaches or migraines when they halt guanfacine too quickly,

  • Nausea and vomiting – Feeling sick to your stomach or throwing up are common withdrawal side effects.

  • Irritability and anxiety – Some individuals may become more irritable, restless or anxious after quitting guanfacine cold turkey.

  • Insomnia – Disrupting guanfacine treatment suddenly can also lead to sleep difficulties.

  • Fatigue – Lack of energy and severe tiredness are also possible.

These withdrawal effects can range from mild to severe depending on the person. They may emerge within 1-2 days after stopping guanfacine and can last for weeks or even months if not properly managed.

Dangers of Abrupt Guanfacine Withdrawal

Quitting guanfacine without slowly tapering under medical supervision carries significant health risks. These include:

  • Severe rebound hypertension that can damage blood vessels and organs.

  • Fainting caused by a sudden drop in blood pressure.

  • Dehydration and electrolyte imbalances from vomiting.

  • Seizures, while rare, have been reported with sudden guanfacine withdrawal.

  • Worsening of ADHD symptoms and oppositional defiant disorder.

  • Increased heart rate and chest pain.

  • Severe rebound anxiety, irritability, or insomnia that disrupts work, school, and relationships.

  • A higher risk of suicidal thoughts especially in children and teens.

For these reasons, it is never advised to stop taking guanfacine abruptly on your own without talking to your doctor first. Doing so can jeopardize your physical and mental health.

Why You Should Not Quit Guanfacine Cold Turkey

There are several important reasons why quitting guanfacine cold turkey is dangerous and should always be avoided:

  • It bypasses the vital tapering process that allows your body to slowly adjust to reducing guanfacine levels. Quitting cold turkey shocks your system.

  • It eliminates medical supervision needed to safely manage withdrawal effects and monitor vital signs.

  • Blood pressure and heart rate changes cannot be controlled without slowly tapering.

  • Cold turkey withdrawal often fails, leading to restarting guanfacine again. This causes more harm.

  • It can lead to medical emergencies like fainting, seizures, or suicidal ideation.

  • The intensity and duration of withdrawal is longer compared to gradually tapering off.

  • It disrupts ADHD treatment progress and control of symptoms.

Essentially, there is no advantage to abruptly stopping guanfacine over properly tapering under medical supervision. Quitting cold turkey almost always leads to more severe and prolonged withdrawal discomfort. Most importantly, it endangers your health both physically and mentally.

How to Safely Stop Taking Guanfacine

If you want to stop taking guanfacine, speak to the doctor who prescribed it first before making any changes. They will advise and monitor you through a gradual tapering process to safely discontinue the medication. This involves incrementally reducing your guanfacine dose over a period of weeks or months.

Your doctor may have you decrease your dose by 1mg or less each week. This gives your body time to slowly adjust to lower guanfacine levels and prevent withdrawal effects. Your doctor will also check your vital signs and watch for any symptoms. Once you are off guanfacine, your doctor will likely continue monitoring your health for a period to ensure you are stable.

While the tapering schedule varies for each patient, following your doctor’s guidance is crucial for safely discontinuing guanfacine without the dangers of cold turkey withdrawal. This reduces the intensity and duration of symptoms so you can stop the medication as comfortably as possible.

Seeking Medical Help for Guanfacine Withdrawal

If you or someone you know has stopped guanfacine suddenly, seek emergency medical care right away before symptoms worsen. Be honest with doctors about halting guanfacine use so they can appropriately treat and monitor any withdrawal effects. In severe cases, hospitalization may be required for stabilizing blood pressure changes and managing intense mental health symptoms.

Your doctor can also prescribe short-term medications to help control specific withdrawal effects like rebound hypertension, anxiety, sleep difficulties or headaches. Ongoing medical supervision is important after quitting guanfacine cold turkey to ensure withdrawal symptoms fully resolve. Most importantly, be transparent with your doctor so you can safely restart guanfacine tapering or explore alternative ADHD treatment options.

Quitting any psychiatric medication cold turkey is never advised. Guanfacine must always be stopped gradually under medical supervision to avoid the dangers of withdrawal. While tapering guanfacine takes patience and discipline, it saves you from the risks and protracted recovery of abrupt withdrawal. Your health and wellbeing is worth the extra time taken to properly discontinue guanfacine.

can you stop guanfacine cold turkey

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5 Substances You Can’t Quit Cold Turkey

FAQ

Do you need to taper off guanfacine?

DOSAGE AND ADMINISTRATION For patients discontinuing guanfacine ER, the dose should be tapered in decrements of no more than 1 mg every three to seven days.

What can happen if you suddenly stop taking guanfacine?

If you suddenly stop taking guanfacine, your blood pressure may increase and you may become nervous or anxious. Your doctor will probably decrease your dose gradually.

Can you take a break from guanfacine?

When discontinuing treatment, or decreasing dosage, patients should work with a doctor to gradually taper the level of medication by no more than 1mg every 3 to 7 days. Stopping guanfacine suddenly can theoretically create withdrawal symptoms including increased heart rate and high blood pressure.

How long does it take guanfacine to get out of your system?

Its half-life is 17 hours (range 10–30 hours) in adults and 13–14 hours in children and adolescents. Its peak time in the serum is 1–4 hours.

Can you stop taking guanfacine suddenly?

It is not recommended that anyone stop taking Guanfacine suddenly without consulting their doctor or healthcare provider first. Abruptly discontinuing Guanfacine use can cause withdrawal symptoms such as anxiety, depression, irritability, insomnia, headaches, nausea, or vomiting, which may persist for weeks or months.

Is it dangerous to quit vaping nicotine cold turkey?

Quitting vaping nicotine ‘cold turkey’ is not dangerous, but it can be very unpleasant. This is because nicotine alters the way your brain functions such that your body feels dependent on it. Some of the unpleasant side effects of quitting abruptly are tremors, headaches, and nausea. These side effects can make it very hard to quit and often cause people to relapse. Fortunately, these unpleasant side effects can be partially or completely avoided by gradually cutting down your use instead of quitting abruptly. Your primary care physician can help you design a plan to quit vaping nicotine.

How often should guanfacine be reduced?

Decrease the dose of guanfacine by 1 mg every 3 to 7 days. As your son was on 3mg of guanfacine, this means he will reduce the dose to 2 mg per day for about a week and then 1 mg per day for about a week and then you can stop. You should not cut or break the guanfacine tablets. The side effects of reducing too fast include:

Is guanfacine safe?

Nothing happened. You can taper off guanfacine, as the FDA directs, by lowering your dose by 1 mg. every five days, or you can just stop. Either seems safe and tolerable. The Key to Reducing Teens’ Risky Behavior?

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